HomeMy WebLinkAboutPermit Plumbing 1995-5-5
RESIDENTIAt
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
"\SSESSORS MAP: / '7 A_~
~OT:
OWNER' (J/~ H r~ E t:./CLI-r,)
ADDRESS: I ~7~ -r;...dOJU"~ s /~
,
CITY:
1::::. /--",r-_ _-"
v
DESCRIBE WORK:
;~w~
NEW
REMODEL
$
1.
CONTRACTOR'S NAME
GENERAL: (t)t..vh~....._
PLUMBING: L/E)'7 /~c0h7~
MECHANICAL:
ELECTRICAL:
'.-'
, ,
.,
9 s I'J 5" 9,C--,
~qlt
2-'7
o L~u7;Hn,~l
~4
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
,J ,., jA I 1_
r oJ
;(;.,1/ 6/{
04 u, r9-7J
, -
BLOCK:
..2:5:4/
STATE:
DA
TAX LOT:
SUBDIVISION:
PHONE: Nd<' /I/S'... _ 7,), '9 '"?C CP_~
ZIP:
,. ?~a7.
~'6-Z:.--J t"3e
ADDITION
DEMOLISH
OTHER
ADDRESS'
CONST.
CONTRACTOR It
PHONE
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to COver.
D Wall I Ceiling Insulation - Prior to
cover.
D Drywall - PrIor to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - Atter
excavation Is compiete. forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted. " .
EXPIRES
?/f'.r
)'g"?.r ~r~ #- ,~7
f
7S"614?
7~/- :;2o~ /
I
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
It OF BLDGS: It OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: It OF BDRMS:
It OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m..wlll be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. '
o Masonry - Steel location, bond
beams, grouting.
o Foundation -After forms are
erected'but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
.:
o Post and Beam - Prior to floor
Insulation or decking. '
/'
o Floor Insulation... Prior to
decking.
K7f' Sanitary Se~er - Prior to filling
~ trench. ,
o Storm Sewer - Prior to filling
trench.
o Water,L1ne - Prior to filling
trench.
o Rough Pl,umblng - Prior to
cover.
D Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
, electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When al/
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
o PJumblng Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
Ins'pectjons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
l;9t sq. ftg: ,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM sa. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Lot TY.
_ Interior
Corner
Panhandle
Cul-de-sac
I P.L.
IN
Is
Iw
LL
','.','
,> ': ~ ,:,~~i~"i'{r~; ,
.. THE PROPOSED WORK tN THE_
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
VALUE
'.
,',
SYSTEMS ~EVELOPMENT CHARGE (SDC)
(B)
PLUMBING, PERMIT
ITEM
Fixtures
Residential Bath(s) NO ,
Sanitary Sewer
Water FT.
Storm Sewer. FT.
Mobile Home
Setbacks '
HSE GAR ACe' I
I APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
X $/SO, FT.
(A~
-7C"'
FT, /,,/
Plumbing Permit
State Surcharge 2. Of:> T / 2.0
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(C)
Dryer Vent
Wood Stove/lnsert/Flreplace Unit
NO
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELL.ftNEOUS PERMITS
Mobile ,Home
State Issuance
State Surcharge
Sidewalk
ft
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
~
4:>,2..0
4- ~ I 2.<)
I
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, Including, the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Pla~s,Revlewed By
. ........ '.
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby cerUfy that all
Information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordlnanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper time; that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
, ~nature lJ- ~/l: J,
Date ?-""5=- rS-
VALIDATION:
RECEIPT NUMBER
DATE PAID
/ '72 5" 2-
,<,- / )" /5'../
, A? ,24
'7-V~ _
. ~..... V"'~L
(
-,
AMOUNT RECEIVED
RECEIVED BY